This fourth piece covers the comments made several senior US government officials:

Ariel Pablos-Méndez, USAID assistant administrator: “Country ownership is far more important now than it was 10 years ago in the global health discourse. We are at an inflection point for the political economy … in which money will change the culture. If we look at overseas development, it accounted for 70 percent of funds in developing countries 50 years ago. Now it accounts for only 13 percent. Domestically, country expenses are expanding dramatically. … Real country ownership will be moving toward the country as the country’s own resources grow. (USAID) used to work in over 100 countries, and now we are in 75, but we’re really focused on 30 countries. It is our wish to get out of a job in a way, but that is more than a generation away. The world is going in a good direction, but we are not there yet.”

Katherine “Kemy” Monahan, deputy executive director of the Global Health Initiative (GHI): “The core of GHI is about working better together. That’s not just US government people. We are talking about saving mothers and children, an AIDS-free generation, and challenging the world. It’s more than donors, countries, or development partners can do alone. We all have to do this together. How are we trying to play this out? There are many, many questions. The US is committed to empowering country systems, country ownership. This is not about a humanitarian effort for us. It’s about empowering leadership, about sustainability.”

“The county is in the driver’s seat, without a doubt, but the country must do its part about what we invest in and to see that there are returns on our investments. We are talking about Congress, too, and what their funding priorities are. … We haven’t been able to give a big pot of general budget support because of accountability issues. … If we want to fund a program that reduces violence against women …the reality is we will spend on those programs. It’s not always one side or the other. It’s not always easy to have to figure out how priorities mesh.”

Amie Batson, deputy assistant administrator for global health, USAID: “At the top levels of the US government we are committed to change. Then it comes to reality, changing bureaucracy, systems, and what you do on Monday morning. We are sitting between all these different and opposing voices. If you ask countries what the US government has done, they will say we don’t listen, don’t dialogue with them and are not very transparent. If you talk to the Hill (Congress) about greater government-to-government funding, you hear that we need to deliver all the results, but we cannot tolerate any risk. Those are hard-earned dollars, and if there is one egregious act, it ends up damaging the whole system. “

“That is the world we sit in. Are we serious (about country ownership)? Yes. Is there a commitment to change? Yes, there is. You can see in Mali how US teams have been engaged with the government, how the teams are working with the government’s national plan. “

“As far as engaging our big implementing partners, … it’s not that we don’t need them, but they need to do a different job. By building that capacity in local institutions, we are trying to change our culture. At the end of the day, thousands of US government employees are making these day-to-day decisions, working to build in different skill bases, and the teams recognize that country ownership is how we will be measured.”

“…We need to be bringing together ministers, up to the Hill directly, with our representatives, so they have a sense of what is country ownership. … This is also about putting the stories out there, not just success stories, but also about all the learning that goes on. The American taxpayer needs to see the value of how the resources are being used.”